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Equine minimally invasive surgical techniques are frequently utilized in the treatment of a variety of conditions. Standing sedated endoscopic surgery is commonly selected in horses, requiring specialized facilities, anesthetic protocols, and surgeon and assistant expertise. This review examines current methods and potential strategies in equine soft tissue surgery, in which there is an emphasis on laparoscopic urogenital and gastrointestinal diagnostic and therapeutic procedures. Thoracoscopy is less frequently reported in horses and may be underutilized. Optimizing procedures and outcomes in soft tissue surgery relies on innovation and interdisciplinary collaboration. Modern advances in surgical equipment and emerging medical technologies support development in these fields. Participation in continuing education is effective in acquiring and sustaining knowledge and skills and improving clinical practice. Forums with an integrated approach could rapidly expand knowledge across species., (© 2024 American College of Veterinary Surgeons.)

Background: The global dairy industry is currently facing the challenge of heat stress (HS). Despite the implementation of various measures to mitigate the negative impact of HS on milk production, the cellular response of dairy cows to HS is still not well understood. Our study aims to analyze transcriptomic dynamics and functional changes in the liver of cows subjected to heat stress (HS). To achieve this, a total of 9 Holstein dairy cows were randomly selected from three environmental conditions - heat stress (HS), pair-fed (PF), and thermoneutral (TN) groups - and liver biopsies were obtained for transcriptome analysis., Results: Both the dry matter intake (DMI) and milk yield of cows in the HS group exhibited significant reduction compared to the TN group. Through liver transcriptomic analysis, 483 differentially expressed genes (DEGs) were identified among three experimental groups. Especially, we found all the protein coding genes in mitochondria were significantly downregulated under HS and 6 heat shock proteins were significant upregulated after HS exposure, indicating HS may affect mitochondria integrity and jeopardize the metabolic homeostasis in liver. Furthermore, Gene ontology (GO) enrichment of DEGs revealed that the protein folding pathway was upregulated while oxidative phosphorylation was downregulated in the HS group, corresponding to impaired energy production caused by mitochondria dysfunction., Conclusions: The liver transcriptome analysis generated a comprehensive gene expression regulation network upon HS in lactating dairy cows. Overall, this study provides novel insights into molecular and metabolic changes of cows conditioned under HS. The key genes and pathways identified in this study provided further understanding of transcriptome regulation of HS response and could serve as vital references to mitigate the HS effects on dairy cow health and productivity., (© 2023. The Author(s).)

Objective: To examine patterns of collaborative research behavior by gender among veterinary academic faculty to determine whether differences exist in how men and women access resources as a contributing factor to the advancement gap., Sample: 710 faculty from 23 veterinary medical colleges., Procedures: An online questionnaire was sent through listservs at participating institutions and data were collected anonymously. Responses related to professional demographics, resources, collaboration, and elements of environmental culture were analyzed to identify associations among variables. Proportional odds logistic regression was utilized to examine the effect of gender on academic rank., Results: Male and female faculty reported participating in collaborations at equal rates. Men were more likely to engage in research collaborations with other men. These collaborations were more common than collaborations between women or between women and men. Men had 47% higher odds of more advanced academic rank compared with women and controlling for relevant factors. While there was no difference in the value of startup packages listed by men and women, women were more likely to report gender as a disadvantage in accessing resources and opportunities., Clinical Relevance: Research productivity is a main factor driving academic promotion. To improve gender equity in career advancement and to support scholarship among all faculty, the creation of institutional development programs focused on facilitating collaborations and resource sharing may be a strategic area for veterinary academic leaders to consider.

Clostridioides difficile infection (CDI) is the leading cause of antibiotic-associated intestinal disease, resulting in severe diarrhea and fatal pseudomembranous colitis. TcdB, one of the essential virulence factors secreted by this bacterium, induces host cell apoptosis through a poorly understood mechanism. Here, we performed an RNA interference (RNAi) screen customized to Caco-2 cells, a cell line model of the intestinal epithelium, to discover host factors involved in TcdB-induced apoptosis. We identified plakoglobin, also known as junction plakoglobin (JUP) or γ-catenin, a member of the catenin family, as a novel host factor and a previously known cell death-related chromatin factor, high-mobility group box 1 (HMGB1). Disruption of those host factors by RNAi and CRISPR resulted in resistance of cells to TcdB-mediated and mitochondrion-dependent apoptosis. JUP was redistributed from adherens junctions to the mitochondria and colocalized with the antiapoptotic factor Bcl-X L . JUP proteins could permeabilize the mitochondrial membrane, resulting in the release of cytochrome c . Our results reveal a novel role of JUP in targeting the mitochondria to promote the mitochondrial apoptotic pathway. Treatment with glycyrrhizin, an HMGB1 inhibitor, resulted in significantly increased resistance to TcdB-induced epithelial damage in cultured cells and a mouse ligated colon loop model. These findings demonstrate the critical roles of JUP and HMGB1 in TcdB-induced epithelial cell apoptosis. IMPORTANCE Clostridioides difficile infection (CDI) is the leading cause of hospital-acquired diarrhea. Toxins, especially TcdB, cause epithelial cell apoptosis, but the underlying cell death mechanism is less clear. Through an apoptosis-focused RNAi screen using a bacterium-made small interfering (siRNA) library customized to a human colonic epithelial cell model, we found a novel host factor, plakoglobin (γ-catenin), as a key factor required for cell apoptosis induced by TcdB. Plakoglobin targets and permeabilizes mitochondria after stimulation by TcdB, demonstrating a hitherto underappreciated role of this catenin family member in the apoptosis of intestinal epithelial cells. We also found a previously known cell death-related chromatin factor, HMGB1, and explored the inhibition of HMGB1 for CDI therapy in vivo .

To evaluate the effects of heat stress (HS) conditions and dietary organic acid and pure botanical (OA/PB) supplementation on gut permeability and milk production, we enrolled 46 multiparous Holstein cows [208 ± 4.65 dry matter intake (DMI; mean ± SD), 3.0 ± 0.42 lactation, 122 ± 4.92 d pregnant, and 39.2 ± 0.26 kg of milk yield] in a study with a completely randomized design. Cows were assigned to 1 of 4 groups: thermoneutral conditions (TN-Con, n = 12), HS conditions (HS-Con, n = 12), thermoneutral conditions pair-fed to HS-Con (TN-PF, n = 12), or HS supplemented with OA/PB [75 mg/kg of body weight (BW); 25% citric acid, 16.7% sorbic acid, 1.7% thymol, 1.0% vanillin, and 55.6% triglyceride; HS-OAPB, n = 10]. Supplements were delivered twice daily by top-dress; all cows not supplemented with OA/PB received an equivalent amount of the triglyceride used for microencapsulation of the OA/PB supplement as a top-dress. Cows were maintained in thermoneutrality [temperature-humidity index (THI) = 68] during a 7-d acclimation and covariate period. Thereafter, cows remained in thermoneutral conditions or were moved to HS conditions (THI: diurnal change 74 to 82) for 14 d. Cows were milked twice daily. Clinical assessments and BW were recorded, blood was sampled, and gastrointestinal permeability measurements were repeatedly evaluated. The mixed model included fixed effects of treatment, time, and their interaction. Rectal and skin temperatures and respiration rates were greater in HS-Con and HS-OAPB relative to TN-Con. Dry matter intake, water intake, and yields of energy-corrected milk (ECM), protein, and lactose were lower in HS-Con relative to HS-OAPB. Nitrogen efficiency was improved in HS-OAPB relative to HS-Con. Compared with TN-Con and TN-PF, milk yield and ECM were lower in HS-Con cows. Total-tract gastrointestinal permeability measured at d 3 of treatment was greater in HS-Con relative to TN-Con or TN-PF. Plasma total fatty acid concentrations were reduced, whereas insulin concentrations were increased in HS-Con relative to TN-PF. We conclude that exposure to a heat-stress environment increases total-tract gastrointestinal permeability. This study highlights important mechanisms that might account for milk production losses caused by heat stress, independent of changes in DMI. Our observations also suggest that dietary supplementation of OA/PB is a means to partly restore ECM production and improve nitrogen efficiency in dairy cattle experiencing heat stress., (© 2022, The Authors. Published by Elsevier Inc. and Fass Inc. on behalf of the American Dairy Science Association®. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).)

Urolithiasis is the most common cause of urinary tract disease in small ruminants and has significant economic and production impacts worldwide. Urolithiasis is multifactorial in origin and generally begins with the formation of cystoliths followed by urethral obstruction. The condition is most common in males. Clinical signs are variable depending on the severity of the obstruction. Uroliths can be calcium, struvite, or silicate based; however, struvite and amorphous magnesium calcium phosphate are the most common urolith types observed in small ruminants. Although urethral process (vermiform appendage) amputation is widely considered the first line of treatment, reobstruction is common within the first 36 hours. Surgical interventions such as temporary tube cystostomy, perineal urethrostomy (PU), modified proximal perineal urethrostomy, vesico-preputial anastomosis (VPA), and urinary bladder marsupialization (BM) are reported to carry an improved prognosis for long-term survival. PU carries a lower proportion of long-term success (> 12-month survival time) when compared with VPA and BM. Stoma stricture and urine scald are the most commonly observed surgical complications. Currently, the literature provides minimal direction for clinician decision-making in managing these cases while accounting for patient history, client financial ability, composition of calculi, and potential treatment complications. Small ruminant urinary obstructions are challenging and complicated conditions to treat, due to their multifactorial etiology, ruminant urogenital anatomy, and the variety of imperfect treatment options available. The purpose of this article this article is to provide veterinary practitioners with decision trees to guide management and treatment of urolithiasis in small ruminants.

Urinary surgery in the horse may be challenging. More straightforward procedures, such as urinary bladder or urachal defects, do not usually require specialized equipment or imaging, although laboratory work is helpful. Congenital or acquired conditions of the ureters or kidneys may necessitate advanced diagnostic work-ups including advanced imaging /or and minimally invasive procedures. Some surgery of the lower urinary tract is done in the sedated, standing adult horse. Surgery involving the kidney typically requires general anesthesia. Laparoscopy and associated tools are frequently used. Although many of the surgical procedures discussed are quite involved, they are becoming more commonplace., (Copyright © 2021 Elsevier Inc. All rights reserved.)

A 7-month-old Hampshire ram, with no history of trauma or breeding, was referred for treatment of acute, unilateral scrotal swelling. Physical examination revealed a moderately sized, soft, left-sided, non-reducible swelling of the proximal scrotum and mild swelling of the scrotal neck. Ultrasound evaluation of the scrotum revealed morphologically normal testicles and a mild accumulation of free fluid in the left vaginal tunic. Unilateral, laparoscopic inguinal herniorrhaphy under general anesthesia was performed. The herniated omentum was reduced and barbed suture was used to imbricate the internal inguinal ring and the vaginal ring. No recurrence of herniation was reported 5 months after surgery. Key clinical message: Laparoscopic inguinal herniorrhaphy with barbed suture can be a safe and effective means of scrotal hernia resolution in a ram. When performed by a competent surgeon experienced in laparoscopy, this treatment for inguinal and scrotal herniation may minimize post-operative pain, provide a rapid return to function, and preserve normal testicular and scrotal anatomy., (Copyright and/or publishing rights held by the Canadian Veterinary Medical Association.)

The Veterinary Internship and Residency Matching Program (VIRMP) recently revised its electronic standardized letter of reference (SLOR) to improve the quality and usefulness of the data obtained from it and to enhance the relevance of non-cognitive and cognitive candidate attributes assessed. We used a stepwise process including a broad survey of SLOR readers and writers, analysis of past SLORs, and a multi-wave iterative revision that included key stakeholders, such as residency and internship program directors from academia and private practice. Data from the SLOR survey and analysis of past SLOR responses identified opportunities to improve applicant differentiation, mitigate positive bias, and encourage response consistency. The survey and other analytics identified and confirmed performance domains of high relevance. The revised SLOR assesses four performance domains: knowledge base and clinical skills, stress and time management, interpersonal skills, and personal characteristics. Ratings within the revised SLOR are predominantly criterion-referenced to enhance discernment of candidate attributes contained within each domain. Questions assessing areas of strength and targeted mentoring were replaced with free-text boxes, which allow writers to comment on positive and neutral/negative ratings of attributes within domains. Minor revisions were made to certain questions to enhance readability, streamline responses, or address targeted concerns identified in the SLOR survey or stakeholder review. The revised SLOR was deployed in the 2020 VIRMP; data from a survey of writers ( n = 647) and readers ( n = 378) indicate that the redesign objectives were achieved.

Objectives: The primary objective of this study was to describe the clinical management and surgical treatment of production size pigs (PrdP) with uterine neoplasia. A secondary objective was to compare tumor diagnoses as well as short- and long-term survival between PrdP and a published report of pot-bellied pigs (PBP) following surgical intervention., Study Design: Retrospective clinical study., Animals or Sample Population: Client-owned PrdP (n = 13) treated with exploratory celiotomy ±ovariohysterectomy for uterine neoplasia., Methods: Medical records from a university hospital were reviewed for historical treatment, presenting complaint, clinical signs, diagnostics, surgical intervention, pathology, and outcome. An online owner survey was performed for follow-up. The novel PrdP cohort was compared to a previously published PBP cohort for differences in tumor diagnoses, surgical complications, and survival. Descriptive statistics, Fischer's exact tests and odds ratios were reported., Results: PrdP were affected by uterine leiomyoma (4/11), leiomyosarcoma (2/11), adenoma (1/11), adenocarcinoma (3/11), and carcinosarcoma (1/11) with no difference in tumor types between PrdP and PBP. PrdP surviving to hospital discharge (6/13) survived at least 1 year postoperatively, with median follow-up of 16 months (14-60 months). PrdP were less likely than PBP to survive in the short-term despite similar frequencies of marked intraoperative hemorrhage. PrdP and PBP had comparable rates of long-term survival following hospital discharge., Conclusion: PrdP are afflicted by similar uterine neoplasia diagnoses as PBP, but they have lower rates of short-term survival to hospital discharge with surgical treatment., Clinical Significance/impact: PrdP have a guarded prognosis for survival to hospital discharge when operated for uterine neoplasia., (© 2021 American College of Veterinary Surgeons.)

Background: Obesity is common in the equine population and it has been associated with increased surgical morbidity and mortality in humans. The effect of increased body mass index (BMI) on the incidence of surgical site infections has not been investigated in horses., Objectives: To determine whether horses with increased body fat, as estimated by BMI, are more likely to develop post-operative complications, particularly incisional complications, following emergency ventral midline celiotomy., Study Design: Retrospective, multi-institutional clinical study., Methods: Medical records of horses >2 years old presenting with colic that underwent ventral midline celiotomy between January 2010 and September 2018 with follow-up of a minimum of 30 post-operative days were reviewed. Extracted data included signalment, operative details and outcome. BMI was calculated by dividing the patient's weight (kg) by the withers height squared (m 2 )., Results: In all, 287 horses fit inclusion criteria. Incisional complication prevalence was 23.7%. Horses with incisional complications had a higher BMI (median 203.6 kg/m 2 , IQR = 191.5-217.4) compared with those without (median 199.1 kg/m 2 , IQR = 184.7-210.2) (P = .03). Multi-variable analysis of the effects of age, sex, breed and presence of metabolic disease on the association between BMI and risk of incisional complications, identified a tendency towards increased risk with a higher BMI, but statistical significance decreased to P = .07. Breed had an association with BMI (P < .01), but not with incisional complication risk., Main Limitations: BMI as an estimate of body fat has limitations. Retrospective studies with reliance on owners reporting data and complete medical records is imperfect. When the data were subjected to multi-variable analysis, the trend towards an increased incidence of incisional complications in horses with higher BMI persisted but it was not statistically significant., Conclusion: Higher BMI may increase the risk for the development of incisional complications in horses following emergency ventral midline celiotomy., (© 2020 EVJ Ltd.)

Objective: To describe the surgical treatment and short- and long-term outcome of young pot-bellied pigs with penile prolapse., Study Design: Short case series., Animals: Five young castrated Vietnamese pot-bellied pigs., Methods: Five Vietnamese pot-bellied pigs presented with penile prolapse of several weeks duration. No other abnormalities were found at physical examination. Under general anesthesia, phallopexy with or without combined urethropexy was performed successfully in all cases., Results: All pigs were discharged from the hospital. One pig required a second urethropexy the day after the initial surgery to improve positioning of the penis in the prepuce. Long-term outcome was available in 4 cases. Penile prolapse resolved in the 4 cases available for follow-up, and the owners were satisfied with the cosmetic outcome of the procedure., Conclusion: Penile prolapse was successfully corrected in 5 pot-bellied pigs by using 2 different phallopexy techniques. The procedure was combined with urethropexy in 3 pigs. Long-term outcome was excellent in the 4 cases available for follow-up., Clinical Impact: This is the first report describing the use of phallopexy with or without urethropexy for successful treatment of penile prolapse in young pot-bellied pigs. Two different phallopexy techniques were effectively used in this report. The etiology of penile prolapse in pot-bellied pigs remains unknown., (© 2019 The American College of Veterinary Surgeons.)

Objective: To describe clinical findings, surgical treatment, and outcome associated with duodenoduodenostomy for treatment of duodenal obstruction secondary to adhesions associated with the sigmoid flexure of the duodenum., Study Design: Retrospective study (1996-2016)., Animals: Fourteen Holstein cattle., Methods: Medical records of cows treated at 3 academic surgical referral centers with duodenoduodenostomy for duodenal obstruction secondary to adhesions associated with the sigmoid flexure of the duodenum were reviewed. Data that were collected included signalment, physical examination results, laboratory results, diagnostic findings, treatments, and survival to discharge. Owners were contacted for follow-up information., Results: Affected cattle ranged in age from 4 months to 5 years. Electrolyte abnormalities, including severe hypochloremia, were present in all cases. Abnormalities included cranial duodenal distension without concurrent distension of the descending duodenum and palpable focal adhesions in the region of the sigmoid flexure of the duodenum. Duodenoduodenostomy involved a stapled (n = 11) or sutured (n = 3) side-to-side anastomosis between the cranial duodenum and descending duodenum. Thirteen of 14 cattle that were treated with duodenoduodenostomy survived to hospital discharge. Long-term follow-up was available in 8 cows, and 7 of those 8 survived for at least 1 year., Conclusion: Short- and long-term survival were favorable after duodenoduodenostomy in cattle with adhesions associated with the sigmoid flexure of the duodenum., Clinical Significance: Duodenoduodenostomy results in acceptable survival and future productivity in cows with obstruction at the sigmoid flexure of the duodenum., (© 2018 The American College of Veterinary Surgeons.)

OBJECTIVE To determine the anatomic location and clinical signs of thymoma in goats and long-term outcomes in a subset of goats treated by tumor excision. DESIGN Retrospective case series. ANIMALS 13 goats with a histologic diagnosis of thymoma at the Cornell University Hospital for Animals between 1990 and 2014. PROCEDURES Medical records of goats with thymoma were reviewed and data were evaluated regarding signalment, clinical signs, diagnostic imaging results, thymoma size, treatment, and outcome. Follow-up information was obtained via contact with the owners and review of medical records. RESULTS 8 goats had a mediastinal mass, 4 had a palpable ventral cervical mass, and 1 had both types of masses. Median age at the time of diagnosis was 9.5 years (range, 3 to 12 years). Goats with a mediastinal mass had respiratory distress or marked tachypnea. Six goats were treated surgically, including all 5 with a ventral cervical mass. All 5 goats with a ventral cervical mass survived with no tumor recurrence for ≥ 1 year after excision. Only 2 goats with a mediastinal mass survived to hospital discharge. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that the prognosis for goats following excision of ventral cervical thymomas was favorable, whereas goats with mediastinal thymomas appeared more likely to have severe clinical signs and a guarded prognosis.

An aged mixed-breed goat doe was presented with a 9-mo history of serosanguineous vaginal discharge. Vaginal speculum examination revealed serosanguineous discharge but otherwise no abnormalities. Transrectal ultrasonography showed normal ovaries and multifocal cystic lesions within the uterus. Ovariohysterectomy was recommended because of a strong suspicion of neoplasia. Multiple, non-resectable masses were noted in and around the uterus intraoperatively, and euthanasia was elected. Autopsy revealed multiple masses within the uterus, cervix, and lung parenchyma. Histologically, the masses within the uterus represented a likely collision tumor of primary adenocarcinoma and leiomyosarcoma. Our report highlights the importance of obtaining biopsy samples of all masses because the lesions described showed significantly different biological behavior. This information is vital to guide treatment and prognosis.

Objectives: To evaluate the veterinary student learning outcome of 2 methods of equine rectal examination training., Study Design: Randomized prospective study., Sample Population: Veterinary students (3rd and 4th year; n = 40) and practicing equine veterinarians (n = 10)., Methods: Year 1: Group 1 (n = 11) and Group 2 students (n = 10) received skilled instructor (SI) and laparoscopic-guidance (LG), respectively, during rectal exam instruction. All students were tested on rectal identification of 4 abdominal organs. Year 2: One group of students (n = 19) was trained and subsequently tested using each technique, first SI, followed by LG. Subjective evaluation of laparoscopy as a teaching tool was achieved with veterinary students and equine practitioners., Results: A significantly greater percentage of students having LG compared to SI were able to correctly identify the left kidney (Year 1) and the spleen, cecum, and right ovary (Year 2). A significantly greater proportion of LG trained students in years 1 and 2 (100% and 95%, respectively) were also able to identify 75% of organs compared with SI (27% and 21%, respectively). Both students and veterinarians uniformly provided favorable feedback for LG in teaching rectal palpation skills., Conclusion: The LG method of equine rectal examination instruction resulted in improved learning for identification of several key abdominal organs compared with SI., (© Copyright 2014 by The American College of Veterinary Surgeons.)

Objective: To evaluate the effects of clopidogrel on clinical and clinicopathologic variables in healthy horses with experimentally induced endotoxemia., Animals: 12 adult mares. Procedures-Horses were assigned with a randomization procedure to receive clopidogrel (4 mg/kg, once, then 2 mg/kg, q 24 h; n = 6) or a placebo (6) through a nasogastric tube. After 72 hours of treatment, horses received lipopolysaccharide (LPS; 30 ng/kg, IV). Heart rate, respiratory rate, rectal temperature, CBC variables, plasma fibrinogen concentration, serum tumor necrosis factor-α concentration, plasma von Willebrand factor concentration, and measures of platelet activation (including ADP- and collagen-induced platelet aggregation and closure times, thrombelastography variables, and results of flow cytometric detection of platelet membrane P-selectin, phosphatidylserine, and microparticles) were determined at various times before and after LPS administration by investigators unaware of the treatment groups. Statistical analyses were performed with repeated-measures ANOVA., Results: 4 of 6 clopidogrel-treated horses had significant decreases in ADP-induced platelet aggregation before and after LPS administration. Heart rate increased significantly after LPS administration only for the placebo group. No significant differences were detected between groups for CBC variables, closure time, and plasma concentration of fibrinogen or serum concentration of tumor necrosis factor-α, and no clinically relevant differences were detected for other hemostatic variables., Conclusions and Clinical Relevance: In this study, administration of LPS did not induce platelet hyperreactivity in horses on the basis of measures of platelet adhesion, aggregation, degranulation, and procoagulant activity. Administration of clopidogrel was associated with variable platelet antiaggregatory activity and attenuated some clinical signs of endotoxemia.

Objectives: To determine the effect of regional limb perfusion (RLP) with amikacin sulfate alone and in combination with ticarcillin/clavulanate on synovial fluid concentration and antimicrobial activity of amikacin., Sample Population: Experimental study., Methods: RLP with amikacin alone (A; 2.5 g) or amikacin and ticarcillin/clavulanate (AT; 2.5 g amikacin, 7 g ticarcillin/clavulanate) was performed with a tourniquet placed at mid-antebrachium in standing, sedated horses. Perfusate blood was collected immediately after injection and again before tourniquet release. Blood from the jugular vein was collected before tourniquet release. Synovial fluid from the middle carpal joint was collected 0, 30, and 60 minutes after tourniquet release. Amikacin concentration and antimicrobial activity of synovial fluid against Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae, and Pseudomonas aeruginosa were determined., Results: There was significantly lower amikacin concentration in the middle carpal joint synovial fluid of group AT compared with group A at 30 minutes (AT = median 4.4 µg/mL, IQR 3.0-11.2 µg/mL; A = 17.5 µg/mL, 6.6-80.1 µg/mL) and 60 minutes (AT = median 4.6 µg/mL, IQR 3.1-8.1 µg/mL; A = 15.0 µg/mL, 6.7-61.7 µg/mL) after tourniquet release. Zones of inhibition for ticarcillin-resistant Klebsiella pneumoniae from group AT were significantly smaller than group A from synovial fluid at 30 and 60 minutes after tourniquet release and in the perfusate serum before tourniquet release., Conclusions: The combination of amikacin with ticarcillin/clavulanate during RLP resulted in significantly lower amikacin synovial concentration and antimicrobial activity on amikacin susceptible and ticarcillin resistant cultures compared with amikacin alone., (© Copyright 2014 by The American College of Veterinary Surgeons.)

Objective: To report surgical management of 4 horses with cryptorchidism caused by failure of regression of the cranial suspensory ligament (CSL)., Study Design: Retrospective case series., Animals: Cryptorchid horses (n = 4)., Methods: Horses with unilateral or bilateral cryptorchidism caused by failure of regression of the CSL were treated by removing the retained testes through a standing laparoscopic approach (2), flank laparotomy (1), or paramedian celiotomy (1). After identification of the retained testis attached to the caudal pole of the kidney by the CSL, the vascular pedicle and ductus deferens were ligated and removed., Results: Two horses had bilateral cryptorchidism and 2 horses had unilateral cryptorchidism. Standing laparoscopic cryptorchidectomy was performed successfully in 2 horses and in 2, the retained testes were removed using a flank or paramedian celiotomy. All testes were located in the dorsal aspect of the abdomen just caudal to the kidney and had a well-developed CSL. All horses recovered successfully from surgery., Conclusions: Failure of regression of the CSL is an uncommon cause of cryptorchidism in horses; however, affected horses can be treated using surgical approaches that facilitate exploration of the dorsocaudal aspect of the abdomen., (© Copyright 2014 by The American College of Veterinary Surgeons.)

Objective: To evaluate the platelet activation response before and after treatment with clopidogrel in horses., Animals: 12 healthy adult mares., Procedures: In a masked study, horses (6/group) were randomly allocated to alternately receive placebo or clopidogrel via nasogastric tube at a loading dose of 4 mg/kg followed by 2 mg/kg every 24 hours. Blood samples were collected before and 72 hours after initiation of treatment for ADP- and collagen-induced light transmission aggregometry; determination of closure time in collagen-ADP cartridges; modified thrombelastography for comparison of maximal amplitudes generated by kaolin, reptilase, and reptilase plus ADP activation; and flow cytometric tests to detect platelet fibrinogen binding, P-selectin expression, and phosphatidylserine externalization before and after ex vivo stimulation with thrombin, convulxin, thrombin with convulxin, and calcium ionophore., Results: Clopidogrel administration induced a significant decrease in mean aggregation response to 5 μM and 10 μM ADP stimulation; however, 2 horses had resistance to clopidogrel's inhibitory action. Significant differences after clopidogrel treatment were not found in any other tests of platelet function., Conclusions and Clinical Relevance: Assays using commercially available reagents were configured to measure different variables of the platelet activation response; however, clopidogrel's platelet inhibitory action was only detected by ADP-induced light transmission aggregometry. Results also suggested that horses, like humans, have interindividual variability in response to clopidogrel that may influence the drug's clinical efficacy as an antiplatelet agent.

Objective: To describe clinical signs and treatment outcomes for juvenile alpacas with spiral colon impaction (SCI)., Design: Retrospective case series. Animals-12 juvenile (< 6 months old) camelids with SCI., Procedures: Crias with SCI were identified by searching the medical records database of the Cornell University Equine and Farm Animal Hospital. A keyword-based search method was used. Inclusion required confirmation of SCI on the basis of surgical or necropsy findings. History, signalment, examination findings, diagnostic test results, medical treatments, and surgical reports as well as short- and long-term outcomes were reviewed. Peritoneal fluid parameters were compared with those of age-matched comparison crias in which SCI was suspected but ruled out at necropsy or exploratory celiotomy., Results: 12 crias with confirmed SCI were identified. Common clinical signs included lethargy and diarrhea. Abdominal distention was observed in 9 crias. In 3 crias, a mass in the region of the spiral colon was palpated. Seven crias underwent peritoneal fluid analysis; compared with age-matched comparison crias, SCI-affected crias had higher peritoneal fluid nucleated cell counts and nucleated cell count-to-total protein concentration ratios. A ventral midline celiotomy was performed in 9 crias; 7 underwent an enterotomy, and 2 underwent transmural infusion of saline (0.9% NaCl) solution with manual breakdown of ingesta; 3 of these crias survived for at least 6 months., Conclusions and Clinical Relevance: Crias with SCI that were not resolved by medical management had a poor prognosis. During celiotomy, transmural infusion of saline solution with manual breakdown of ingesta provided a less invasive alternative to enterotomy.

This report describes a modification of the parainguinal approach for removal of cystic calculi: a ventral midline laparotomy-guided parainguinal laparocystotomy. The ventral midline approach to the abdomen is rapid and routinely used by equine surgeons. With an arm introduced to the abdomen via the ventral midline, the surgeon is able to select the ideal parainguinal laparotomy incision location that allows bladder exteriorisation with the minimum amount of tension. Because the surgeon's hand is introduced via the ventral midline incision, the parainguinal incision can be sized to just allow exteriorisation of the urinary bladder and urolith, increasing extra-abdominal bladder security during cystotomy while reducing incision size in the parainguinal region. Finally, an assistant's hand via the ventral midline incision can maintain bladder stability within the parainguinal incision during cystotomy closure., (© 2012 EVJ Ltd.)

The impact of Clostridium difficile infection (CDI) on healthcare is becoming increasingly recognized as it represents a major cause of nosocomial diarrhea. A rising number of CDI cases and outbreaks have been reported worldwide. Here, we developed the pig ileal-ligated loop model for semi-quantitative analysis comparing temporal differential proteomes in C. difficile following in vivo incubation with in vitro growth using isobaric tags for relative and absolute quantification (iTRAQ). Proteins retrieved from the in vitro cultures and the loop contents after 4, 8, and 12 h in vivo incubation were subjected to in-solution digestion, iTRAQ labeling, two-dimensional liquid chromatography/tandem mass spectrometry and statistical analyses. From a total of 1152 distinct proteins identified in this study, 705 proteins were available for quantitative measures at all time points in both biological and technical replicates; 109 proteins were found to be differentially expressed. With analysis of clusters of orthologous group and protein-protein network interactions, we identified the proteins that might play roles in adaptive responses to the host environment, hence enhancing pathogenicity during CDI. This report represents the quantitative proteomic analysis of C. difficile that demonstrates time-dependent protein expression changes under conditions that mimic in vivo infection and identifies potential candidates for diagnostic or therapeutic measures.

Objective: To identify hemostatic imbalances indicative of an increased risk of intra-abdominal adhesion formation in foals versus adult horses., Animals: Horses with colic undergoing exploratory laparotomy or abdominocentesis as part of a clinical examination (n = 16 foals ≤ 6 months of age and 19 adults ≥ 5 years of age) and horses without colic undergoing herniorrhaphy (15 foals) or euthanasia for noninflammatory and nongastrointestinal disease (10 foals and 20 adults)., Procedures: Paired abdominal fluid and blood samples were collected from each horse into buffered sodium citrate and centrifuged immediately after collection. Supernatants were stored at -80°C, then thawed for measurement of fibrinogen concentration, plasminogen activity, antiplasmin activity, and D-dimer concentration. Supernatant analyte concentrations or activities were compared within age group (foals with and without colic vs adults with and without colic) and within disease status (foals and adults without colic vs foals and adults with colic)., Results: All analyte concentrations or activities in abdominal fluid samples were significantly lower in the noncolic groups than in the colic groups, and none differed between foal and adult groups. Several plasma analyte values differed by disease status and age., Conclusions and Clinical Relevance: The risk of intra-abdominal adhesion formation in the foals in this study did not appear to be attributable to differences in intra-abdominal hemostasis between adult horses and foals. Strategies for initial medical and surgical management of colic in adult horses may be applicable to foals with similar disorders.

Objective: To investigate the efficacy and safety of a low-volume, single-catheter, continuous peripheral neural blockade (CPNB) technique to locally deliver bupivacaine to alleviate signs of severe forelimb pain resulting from experimentally induced tendonitis in horses., Design: Randomized controlled experimental trial., Sample: 14 horses and 5 forelimbs from equine cadavers., Procedures: Horses underwent collagenase-induced superficial digital flexor tendonitis in the midmetacarpal region of 1 forelimb. To deliver analgesia, a closed-tip catheter was placed from lateral to medial, approximately 12 cm distal to the accessory carpal bone, between the suspensory ligament and accessory ligament of the deep digital flexor tendon. Success of catheter placement and anesthetic delivery was documented ex vivo in 5 forelimbs from equine cadavers. Effective analgesia in affected forelimbs of horses from continuous (n = 7) versus intermittent (7) local anesthetic delivery (intermittent peripheral neural blockade; IPNB) was compared over a 3-day period., Results: Horses that received CPNB in the affected forelimb were less lame than horses that received IPNB. A lower proportion of CPNB-treated horses had behavioral and physiologic signs of pain, compared with IPNB-treated horses. Neither technique completely blocked the sensation of pain or resulted in swelling in the distal portion of the forelimb, vasodilation, or an increase in lameness. After removal, Staphylococcus aureus was cultured from 1 catheter tip., Conclusions and Clinical Relevance: For short-term treatment, CPNB was more effective than IPNB for reduction in signs of severe pain in the distal aspect of the forelimb of horses.

Objectives: To determine (1) the short- (to hospital discharge) and long- (>6 months) term survival, (2) factors associated with short-term survival, and (3) the perioperative course for horses with resection and anastomosis of the descending colon., Study Design: Multicentered case series., Animals: Horses (n=43) that had descending colon resection and anastomosis., Methods: Medical records (January 1995-June 2009) of 7 equine referral hospitals were reviewed for horses that had descending colon resection and anastomosis and were recovered from anesthesia. Retrieved data included history, results of clinical and clinicopathologic examinations, surgical findings, postsurgical treatment and complications, and short-term survival (hospital discharge). Long-term survival was defined as survival > or =6 months after hospital discharge., Results: Of 43 horses, 36 (84%) were discharged from the hospital. Twenty-eight of 30 horses with follow-up information survived > or =6 months. No significant associations between perioperative factors and short-term survival were identified. Lesions included strangulating lipoma (n=27), postfoaling trauma (4), infarction (4), intraluminal obstruction (2), and other (6). Common postoperative complications included fever and diarrhea. During hospitalization 7 horses were euthanatized or died because of septic peritonitis (3), endotoxemia (3), and colic and ileus (1)., Conclusions: Descending colon resection and anastomosis has a favorable prognosis for hospital discharge and survival > or =6 months. The most common cause of small colon incarceration was strangulating lipoma., Clinical Relevance: Complications include postoperative fever and diarrhea but the prognosis is good after small colon resection and anastomosis.

Prebiotics may enhance iron bioavailability by increasing iron absorption in the colon. Anemic pigs fitted with cecal cannulas were fed a low-iron diet with or without 4% inulin. Over 7 days, pigs were administered 1 mg of (54)Fe in the morning feed followed by cannula infusion of 0.5 mg of (58)Fe to measure total and colonic iron absorption, respectively. Whole blood was drawn prior to the initial dosing and 14 days thereafter for hemoglobin concentration and stable isotope ratio analyses. The prebiotic role of inulin was confirmed by increases in lactobacilli and bifidobacteria with reductions in clostridia using terminal restriction fragment length polymorphism (TRFLP). Total iron absorption was 23.2 +/- 2.7 and 20.7 +/- 3.5% (mean +/- SEM; p > 0.05), while colonic iron absorption was 0.4 +/- 0.1 and 1.0 +/- 0.2% (mean +/- SEM; p > 0.05) in inulin-fed and control pigs, respectively. These results show that the colon does not make a significant contribution to total iron absorption in iron-deficient pigs and that inulin does not affect iron absorption in the colon.

Objective: To compare the analgesic efficacy of buprenorphine plus detomidine with that of morphine plus detomidine when administered epidurally in horses undergoing bilateral stifle arthroscopy., Study Design: Prospective, randomized, blinded clinical trial., Animals: Twelve healthy adult horses participating in an orthopedic research study. Group M (n = 6) received morphine (0.2 mg kg(-1)) and detomidine (0.15 mg kg(-1)) epidurally; group B (n = 6) received buprenorphine (0.005 mg kg(-1)) and detomidine (0.15 mg kg(-1)) epidurally., Methods: Horses received one of two epidural treatments following induction of general anesthesia for bilateral stifle arthroscopy. Heart rate (HR), mean arterial blood pressure (MAP), end-tidal CO(2) (Pe'CO(2)), and end-tidal isoflurane concentrations (E'Iso%) were recorded every 15 minutes following epidural administration. Post-operative assessment was performed at 1, 2, 3, 6, 9, 12, and 24 hours after standing; variables recorded included HR, respiratory rate (f(R)), abdominal borborygmi, defecation, and the presence of undesirable side effects. At the same times post-operatively, each horse was videotaped at a walk and subsequently assigned a lameness score (0-4) by three ACVS diplomates blinded to treatment and who followed previously published guidelines. Nonparametric data were analyzed using Wilcoxon's rank-sum test. Inter- and intra-rater agreement were determined using weighted kappa coefficients. Statistical significance was set at p

Objective: To determine the effect of nonthermal plasma on Staphylococcus aureus, fibroblasts in monolayer culture, and clean and contaminated skin explants., Sample Population: Normal skin from euthanized horses., Procedures: S aureus organisms were plated and treated with nonthermal plasma followed by bacterial culture to assess viability. Fibroblasts in monolayer culture and the epidermal and dermal surfaces of clean and S aureus-contaminated skin explants were treated. The effects of distance and duration on the response to treatment were compared., Results: Compared with controls, treatment with nonthermal plasma resulted in significantly decreased bacterial growth and significantly inhibited survival of fibroblasts in monolayer culture. When epidermal and dermal surfaces of skin explants were treated, there was no effect on production of normal fibroblasts during explant culture, except when extended exposure times of >or= 2 minutes were used. Treatment with nonthermal plasma resulted in significantly lower bacterial counts after 24 hours of culture of S aureus-contaminated epidermis but not of dermis., Conclusions and Clinical Relevance: Nonthermal plasma resulted in bacterial decontamination of agar and epithelium; negative effects on fibroblasts in monolayer; and no negative effects on skin explants, except at long exposure times. Use of nonthermal plasma appears safe for treatment of epithelialized surfaces, may be safe for granulating wounds, and results in decontamination of S aureus. Investigations on the effects that nonthermal plasma may have on patient tissues are indicated with a clinically applicable delivery device.

Objectives: To determine the requirement for 2nd surgical interventions and mortality after 3 different surgical techniques (percutaneous tube cystostomy [10 goats], surgical tube cystostomy [25 goats], urinary bladder marsupialization [10 goats]) for caprine obstructive urolithiasis, and to determine whether pre- or 24-hour postoperative physical examination findings or serum chemistry results could be used as predictors of mortality., Study Design: Retrospective study., Animals: Male goats (45) with obstructive urolithiasis., Methods: Medical records for all male goats admitted and operated for obstructive urolithiasis between 1993 and 2003 were reviewed. Data retrieved included signalment, pre- and 24-hour postoperative values for temperature, pulse, respiratory rate, packed cell volume, serum K(+), serum creatinine, and blood urea nitrogen [BUN]. The type of initial surgical procedure, time to 2nd surgical intervention, time to death, and duration and cost of hospitalization were also obtained., Results: Percutaneous tube cystostomy was associated with a significantly increased requirement for (5.6-fold increased hazard) and decreased time to a 2nd intervention (P=.002). There were no differences between the 3 procedures for time to mortality. Increased BUN and respiratory rate at admission were associated with increased mortality (hazards ratio of 4.8 and 5.0, respectively). Urinary bladder marsupialization was associated with significantly decreased hospitalization time (P=.02) and cost (P=.04) compared with surgical tube cystostomy and percutaneous tube cystostomy., Conclusion: Surgical tube cystostomy and bladder marsupialization are both acceptable surgical methods for treatment of caprine obstructive urolithiasis. Each procedure has inherent complications that should be discussed with the owner before choosing the surgical treatment., Clinical Relevance: There are acceptable options for treatment of caprine obstructive urolithiasis; however, percutaneous tube cystostomy should be avoided.

Objective: To describe a surgical technique for radical mastectomy in ruminants and to report experience and outcome in 20 animals., Study Design: Retrospective study., Animals: Seventeen goats and 3 cows., Methods: Medical records of ruminants that had radical mastectomy between June 1, 1987 and June 1, 2003 were reviewed. Follow-up information was obtained by telephone interview of owners., Results: One animal died within 24 hours from complications of gangrenous mastitis and another died from necrotizing cellulitis. Eighteen animals were discharged and follow-up information was available for 15 animals; 12 animals lived at least 1 year postoperatively., Conclusions: Ruminants with severe but localized diseases of the udder did well after radical mastectomy. The procedure was well tolerated, made the animals more comfortable, and potentially prolonged their lives as pets., Clinical Relevance: Radical mastectomy can be a safe and effective procedure for ruminants with udder disease, with few complications.

Objective: To determine whether preoperative epidural administration of morphine and detomidine would decrease postoperative lameness after bilateral stifle arthroscopy in horses., Study Design: Prospective clinical controlled study., Animals: Eight adult horses that had bilateral arthroscopic procedures, including drilling of cartilage and subchondral bone within the femoropatellar joints., Methods: Horses were randomly separated into 2 groups. Preoperatively, 4 horses were administered a combination of epidural morphine (0.2 mg/kg) and detomidine (30 microg/kg), and 4 horses were administered an equivalent volume of epidural saline (0.9% NaCl) solution. Postoperative pain was assessed using 6 video recordings made at hourly intervals of each horse at a walk. Assessments began 1 hour after recovery from anesthesia. The recordings were scrambled out of sequence and evaluated by 3 observers, unaware of treatment groups, who scored lameness from 0 to 4. Lameness scores of the 2 groups of horses were compared using a Wilcoxon's rank sum test. Heart and respiratory rates were also measured at each hourly interval and compared between groups using a repeated-measures ANOVA; statistical significance was set at P <.05., Results: Preoperative administration of epidural morphine and detomidine significantly decreased lameness and heart rates after bilateral stifle arthroscopy. The greatest decrease was detected at hours 1 and 2 after recovery from anesthesia., Conclusion: We conclude that horses undergoing a painful arthroscopic procedure of the stifle joint benefit from the administration of preoperative epidural morphine and detomidine., Clinical Relevance: Preoperative epidural administration of detomidine and morphine may be useful in decreasing postoperative pain after stifle arthroscopy as well as pain associated with other painful disorders involving the stifle joint, such as septic arthritis and trauma., (Copyright 2002 by The American College of Veterinary Surgeons)

Experimental evidence suggests that recommended dosages of some corticosteroids used clinically as antiinflammatory agents for treating arthropathies damage articular cartilage, but low dosages may be chondroprotective. The purpose of this study was to evaluate how different concentrations of methylprednisolone affect chondrocyte function and viability. Articular cartilage and chondrocytes were obtained from young adult horses, 1.5-3.5 years of age. Corticosteroid-induced changes in collagen expression were studied at the transcriptional level by Northern blot analyses and at the translational level by measuring [3H]-proline incorporation into [3H]-hydroxyproline. Fibronectin mRNA splicing patterns were evaluated with ribonuclease protection assays. Cytotoxicity was studied using erythrosin B dye exclusion. Steady-state levels of type II procollagen mRNA decreased without concurrent changes in type I procollagen expression as the medium methylprednisolone concentrations were increased from 1 x 10(1) to 1 x 10(8) pg/ml, dropping below 10% of control values by 1 x 10(5) pg/ml. Cytotoxicity occurred as methylprednisolone levels were increased further from 1 x 10(8) to 1 x 10(9) pg/ml. Changes in total collagen (protein) synthesis were less pronounced, but also demonstrated significant suppression between 1 x 10(4) and 1 x 10(8) pg/ml. Corticosteroid-induced changes in fibronectin isoform levels were evaluated in articular cartilage samples without in vitro culture. The cartilage-specific (V + C)(-) isoform was suppressed in both normal and inflamed joints by a single intraarticular injection (0.1 mg/kg) of methylprednisolone. Combined, these data indicate that methylprednisolone suppresses matrix protein markers of chondrocytic differentiation. Decreased and altered chondrocyte expression of matrix proteins likely contributes to the pathogenesis of corticosteroid-induced cartilage degeneration.

Objective: To study in vitro (1) the dose-response relationships between proteoglycan metabolism in normal and corticosteroid-treated articular cartilage; (2) long-term proteoglycan metabolism after treatment of articular cartilage with corticosteroids; and (3) the effect of corticosteroids on proteoglycan metabolism in articular cartilage treated with monocyte-conditioned medium (MCM)., Study Design: Equine and canine articular cartilage explants were treated with corticosteroids and MCM. Proteoglycan synthesis and degradation were measured by radioactive labeling in short-term culture, and the long-term effect of corticosteroid treatment on proteoglycan metabolism was studied in normal explants., Animals: Two young cross-breed horses and 3 young Labrador retrievers., Methods: Equine articular cartilage explants were incubated in medium containing methylprednisolone sodium succinate (MPS) at 0, .001, .01, .1, 1, and 10 mg/mL (final concentration) for 1 day and then in fresh medium without MPS. Proteoglycan synthesis was measured by incorporation of sodium [35S]sulfate at 1, 3, 7, 10, and 13 days after initial treatment with MPS. Proteoglycan release was measured from separate explants prelabeled with sodium [35S]sulfate and treated similarly. Equine articular cartilage explants were treated with equine MCM simultaneously with, and 24 hours before MPS, at 0, 0.01, 0.1, 1, or 5 mg/mL for 72 hours. Proteoglycan synthesis and degradation in these explants was compared. Proteoglycan synthesis and degradation were measured similarly in canine articular cartilage explants treated simultaneously with canine MCM and MPS at 0, 0.001, 0.01, 0.1, 1 and 10 mg/mL for 72 hours. Equine articular cartilage explants treated with 0, 0.01, 0.1, 1, and 5 mg/mL of MPS for 72 hours were evaluated histologically., Results: Proteoglycan synthesis in normal equine articular cartilage was severely depressed by 10 mg/mL MPS for 24 hours, and proteoglycan synthesis failed to recover after 13 days of culture in medium without MPS. Cartilage treated with 5 mg/mL MPS had pyknotic chondrocyte nuclei and empty lacunae. Concentrations of 1 and 0.1 mg/mL MPS depressed proteoglycan synthesis in normal equine cartilage explants. For these 2 concentrations, proteoglycan synthesis recovered 2 days after MPS removal and increased significantly (P < .05) 7 days after treatment with MPS compared with controls without MPS. Concentrations of 0.001 and 0.01 mg/mL MPS did not significantly affect proteoglycan synthesis in normal equine cartilage explants. Cumulative proteoglycan loss over 13 days in culture from normal equine explants treated for 24 hours with different concentrations of MPS was not significantly different between treatment groups at any time point. MCM significantly depressed proteoglycan synthesis in both canine and equine articular cartilage explants and significantly increased proteoglycan release. These effects were prevented in the canine explants by simultaneous treatment with MPS at 1 and 0.1 mg/mL, and proteoglycan release induced by MCM in equine articular cartilage was inhibited by 1 mg/mL MPS., Conclusions: Concentrations of 1.0 and 0.1 mg/mL MPS alleviated articular cartilage degradation in MCM-treated articular cartilage in vitro. These concentrations of MPS in contact with normal cartilage explants for 24 hours are unlikely to be detrimental in the long term to proteoglycan synthesis. The response of articular cartilage to MPS was affected by treatment with MCM so that results of experiments with normal articular cartilage explants may not reflect results obtained with abnormal cartilage., Clinical Relevance: It may be possible to find an intraarticular concentration of corticosteroid that protects articular cartilage against cytokine-induced matrix degradation yet not have prolonged or permanent detrimental effects on chondrocyte matrix synthesis.

Between July 1, 1983 and December 31, 1990, risk factors were determined for all horses with joint disease presented to a referral center, of being discharged, of ever becoming sound, or of being alive at 3 mo follow-up. Logistic multiple-regression models were done separately for foals (< or = 4 mo), yearlings (> 4-24 mo) and racing or nonracing adult horses (> 24 mo). The breakdown in this study was 53 foals, 87 yearlings, 141 nonracing adults, and 226 racing adults. Thirty-one foals (58%), 68 yearlings (78%), 119 non-racing adults (84%), and 213 racing adults (94%) were discharged. Foals with a less severe lameness, duration of illness of > 1 d, and infectious arthritis had increased odds of discharge. At follow-up, 12 of 18 (67%) were alive, 10 (56%) of which were sound. Yearlings with osteochondrosis had higher odds of discharge; at follow-up, 38 of 49 (78%) were alive, 32 (65%) of which were sound. For non-racing adults, horses with less severe lameness, without a miscellaneous diagnosis, or intended for pleasure use had increased odds of discharge. At follow-up, 55 of 78 (70%) were alive and 33 of 58 (57%) with soundness data became sound. Risk factors for higher odds of being alive at follow-up were carpal lameness, arthroscopic surgery, a prognosis other than poor, became sound, above-median hospitalization costs, and duration of follow-up. The 161 racing adults (76% of discharges), with follow-up, were more likely to have had osteoarthritis, higher hospital costs, hospitalization > 1 d, and arthroscopy. Sixty-four (60%) of these became sound; the odds increased if the horse was not severely lame at admission or was hospitalized for > 1 d. Risk factors and prognosis differed by age-use group among horses seen at our hospital.

Objective: To determine whether steady-state levels of type-II procollagen, aggrecan core protein, or fibronectin mRNA in articular chondrocytes are altered by synovitis or administration of methylprednisolone acetate (MPA)., Sample Population: Articular cartilage specimens collected from 10 ponies, 2.5 to 3.5 years old and 200 to 300 kg., Procedure: 4 experimental groups were compared, using the cartilage specimens: control, MPA-treated, lipopolysaccharide-induced synovitis, and lipopolysaccharide-induced synovitis with MPA treatment. RNA was isolated from articular cartilage and compared by northern blot analysis, using equine-specific cDNA probes., Results: Synovitis increased steady-state levels of type-II procollagen mRNA fivefold and of aggrecan mRNA twofold. Administration of a single intra-articular injection of MPA (0.1 mg/kg of body weight) decreased type-II procollagen transcripts in normal cartilage sixfold, without significant effect on aggrecan or total fibronectin mRNA values. MPA treatment of inflamed joints decreased type-II procollagen and aggrecan mRNA to levels that were not significantly different from those in untreated control specimens., Conclusions: Articular chondrocytes increase type-II procollagen and aggrecan synthesis in response to synovitis. MPA alters chondrocyte function in normal and inflamed cartilage, suggesting that potential changes in cartilage matrix protein synthesis should be considered when evaluating the therapeutic value of intra-articular administration of corticosteroids., Clinical Relevance: Knowledge of how synovitis and corticosteroids (independently and in combination) affect synthesis of cartilage matrix proteins is relevant to understanding pathogenesis of traumatic osteoarthritis and improving therapeutic strategies.

Contrast radiographic visualization of the small ruminant and porcine lower urinary tract is an infrequently used modality for the evaluation and management of obstructive urolithiasis. The administration of contrast medium through a tube cystostomy catheter used to divert urine flow until the resolution of the obstruction may provide an easy method to evaluate the status of the urethral obstruction. Contrast fluoroscopy is utilized to monitor and visualize therapeutic flushing of the urethra. A review of 26 patients seen at the Veterinary Medical Teaching Hospital suggested that among the radiographic techniques used, positive contrast normograde cystourethrography through the tube cystostomy catheter allowed the best visualization of the lower urinary tract structures and enabled assessment of the resolution of the obstructive lesion.

Objective: To evaluate the association of physical examination and clinicopathologic findings with surgical findings in cattle with concurrent abomasal displacement and perforating ulceration, to determine short- and long-term survival rates in these cattle, and to determine whether degree of peritonitis (focal vs diffuse) influences survival rates., Design: Retrospective study., Animals: 21 cattle with concurrent abomasal displacement and perforating ulceration and 42 cattle with uncomplicated abomasal displacement., Procedure: Information on signalment, stage of lactation, physical examination findings, clinicopathologic data, surgical diagnosis, procedure(s) performed, and necropsy findings were retrieved from medical records of all cattle included in this study. Differences between physical examination findings of cattle with concurrent disease and those of cattle with uncomplicated displacements were evaluated, as were differences between survival rates in cattle with focal versus diffuse peritonitis., Results: Cattle with concurrent disease had a greater probability of having pneumoperitoneum and signs of abdominal pain identified on physical examination than did cattle with uncomplicated diseases. There was no relationship between clinicopathologic data and survival time. Short-term survival rate was 38%, and degree of peritonitis significantly influenced survival time in cattle with concurrent abomasal displacement and perforating ulceration. Long-term survival rate in these cattle was 14%., Clinical Implications: Cattle with concurrent displaced abomasum and perforating ulceration have a poor chance for survival. In addition to detection of displaced abomasum, physical examination findings that can help lead to a presurgical diagnosis of this syndrome are pneumoperitoneum and signs of abdominal pain.

Objective: To determine how acute synovitis, with and without intra-articular methylprednisolone acetate (MPA), affect synthesis of proteoglycan, total protein, and collagen in articular cartilage and total protein synthesis in synovial membrane., Design: Synovitis was induced in 10 ponies by the injection of 0.5 ng lipopolysaccharide (LPS) into the left radiocarpal and midcarpal joints every 2 days for a total of four treatments. Synovitis was documented by clinical examination and synovial fluid analyses. Two days before euthanasia, MPA (0.1 mg/kg) was injected with the last dose of LPS into both the left and right radiocarpal and midcarpal joints of five of these ponies. Proteoglycan synthesis in articular cartilage explants from these joints was measured by incorporation of sodium [35S]sulfate. The size of the proteoglycan monomers and their aggregation with hyaluronan was assessed by size-exclusion chromatography. Protein synthesis in articular cartilage was measured by incorporation of [3H]proline and collagen synthesis by conversion of [3H]proline into [3H]hydroxyproline. Protein synthesis was measured in synovial membrane explants by incorporation of [35S]methionine., Results: Ponies developed carpal effusion and mild lameness accompanied by increased total nucleated cell count and total solids in synovial fluid in response to the LPS injections. Moderate to severe synovial membrane proliferation and inflammation were observed histopathologically in joints injected with LPS but no consistent light-microscopical changes were observed in the articular cartilage from these joints. Intra-articular MPA alone was associated with decreased proteoglycan synthesis and increased protein and collagen synthesis in the cartilage explants. Total protein synthesis by synovial membrane was also increased by MPA alone. In contrast, no differences in protein or proteoglycan synthesis were observed in explants from the joints with synovitis, with or without intra-articular MPA. Treatment with MPA, LPS, and LPS/MPA did not alter proteoglycan aggregate size, but LPS-induced synovitis resulted in an increase in the second largest population of monomers. MPA increased the synthesis of small proteoglycan monomers., Conclusion: Based on the methods used, acute synovitis prevented changes induced by intra-articular MPA alone. Results suggested that the effect of intra-articular MPA on joint metabolism was different between inflamed and normal joints. Experimental studies must consider the effect of inflammation, as well as the potential to introduce in vitro culture artifacts when investigating the effect of intra-articular corticosteroids on chondrocyte function.

The case records of 119 young horses (all less than age one year) that underwent an exploratory celiotomy during a 17 year period were examined to determine the surgical findings, short- and long-term outcome, and prevalence of small intestinal disease compared to previous reports in the mature horse. Physical and laboratory values were compared for long-term survivors vs. nonsurvivors and the frequency of post operative intra-abdominal adhesions was determined. The most common cause for exploratory celiotomy was small intestinal strangulation, followed by enteritis and uroperitoneum. Six horses died during surgery, 23 were subjected to euthanasia at the time of surgery due to a grave prognosis, and 17 horses died or were destroyed after surgery, prior to discharge from the hospital; the short-term survival was 61%. Nine horses were lost to follow-up. Forty-one horses survived long-term (at least 6 months after surgery), 15 died or were subjected to euthanasia after discharge for reasons related to the prior abdominal surgery, and 8 died or were destroyed after discharge due to unrelated reasons, making the long-term survival 45%. Fifty-three (45%) of the horses presented as neonates, and 66 (55%) presented age 3-12 months. Uroperitoneum and meconium impaction were the most common disease in the neonate. Intussusception and enteritis were the most common diseases in older foals. The overall prevalence of small intestinal disease was 44%. Significant elevations in packed cell volume, heart rate, nucleated cell counts and total protein in abdominal fluid and rectal temperature were observed in nonsurvivors compared to survivors. Nonsurvivors had significantly decreased serum bicarbonate, chloride, sodium, and venous pH values. There was no evidence that location of the lesion affected long-term survival. Horses with a simple obstruction had a higher survival percentage than those with a strangulating obstruction, and horses that underwent an intestinal resection had a lower long-term survival than those horses undergoing only intestinal manipulation. Nineteen (33%) of the foals examined after the original surgery had evidence of intra-abdominal adhesions. Nine of these (16%) had adhesions that caused a clinical problem.

Objective: To determine whether keratan sulfate concentrations in plasma or synovial fluid from clinically normal horses were different from concentrations in horses with joint disease and whether concentrations varied with type of joint disease., Design: Case-control study., Animals: 67 clinically normal horses, 10 clinically normal foals, and 160 horses with joint disease., Procedure: ELISA was used to measure keratan sulfate concentrations., Results: Mean plasma keratan sulfate concentration (mean +/- SEM, 580 +/- 124 ng/ml) in foals peaked at 10 weeks of age. Mean plasma keratan sulfate concentration in clinically normal horses was 200 ng/ml (95% confidence interval, 157 to 251 ng/ml). Horses with osteochondral (chip) fractures, other closed intraarticular fractures, inflammatory arthritis (synovitis), infectious arthritis, or osteochondrosis had significantly higher plasma keratan sulfate concentrations than did clinically normal horses, but horses with osteoarthritis did not. Breed, gender, and type of joint disease affected keratan sulfate concentration in synovial fluid. Standard-breds with chip fractures of the metacarpophalangeal/ metatarsophalangeal joints had significantly higher keratan sulfate concentrations in synovial fluid than did Thoroughbreds. Keratan sulfate concentrations in synovial fluid from osteoarthritic carpal joints were lower than concentrations in normal carpal joints and tarsocrural joints with inflammatory joint disease., Clinical Implications: Keratan sulfate concentration alone was not a specific marker of joint disease but was affected by various joint diseases.

Objective: The effect of different doses of methylprednisolone acetate (MPA) on proteoglycan and collagen metabolism of articular cartilage from normal equine joints was tested in vitro., Methods: Cultured explants were treated with 0, 0.0004, 0.004, 0.04, 0.4 and 4.0 mg/ml (approximately 10(-6)-10(-2) M) MPA for 72 h. Proteoglycan synthesis was measured by incorporation of sodium [35S]sulfate into proteoglycans and proteoglycan degradation was measured by release of total and radiolabeled proteoglycan into the culture media. The size of the proteoglycans was assessed with size exclusion chromatography under both associative and dissociative conditions. Total protein synthesis was measured by incorporation of [3H]proline and collagen synthesis by formation of [3H]hydroxyproline., Results: Treatments of 0.0004, 0.004, and 0.04 mg/ml MPA caused a significant (p < 0.05) increase in total protein synthesis compared to the control, and doses of 0.0004 and 0.004 mg/ml MPA tended to increase (p < 0.1) collagen synthesis. In contrast, MPA doses of 0.04 mg/ml or less had no effect on proteoglycan synthesis compared to control. Proteoglycan, total protein, and collagen synthesis were severely depressed with the 0.4 and 4.0 mg/ml MPA treatments. The lowest doses of MPA had minimal effect on proteoglycan degradation, while 0.4 and 4.0 mg/ml MPA decreased degradation of total proteoglycan in a dose dependent fashion. Degradation of newly synthesized proteoglycan in the explants was significantly decreased (p < 0.05) by 4.0 mg/ml MPA. There was positive correlation (r = 0.83, p < 0.05) between the effect of MPA on proteoglycan synthesis and the release of total proteoglycan into the culture media. Chromatography under associative conditions showed that treatment with MPA (0.4 and 0.004 mg/ml) decreased the size and increased the polydispersity of aggrecan and induced synthesis of the small nonaggregating proteoglycans. Aggrecan monomers from cartilage treated with MPA included a population of smaller monomers, which resulted in greater polydispersity than those from control cartilage., Conclusion: As well as decreasing synthesis, loss of proteoglycan from MPA treated cartilage in vivo may be partly due to the synthesis of a population of smaller proteoglycans than those extracted from untreated cartilage, and these may not interact with hyaluronan and may not be retained permanently in the matrix. Methylprednisolone acetate may affect posttranslational modification of the core protein with the addition of smaller and possibly fewer glycosaminoglycan chains.